Spiritual pain 

 

This is common in most patients as they approach death and is dfined by Saunders as ''The realization that life is likely to end soon may well give rise to feelings of unfairness of what is happening, and above all a desolate feeling of meaningless.

 

This may be presented as:

 

• Anger

• Feeling of 'why me' i.e unfairness

• Confusion of why God allows suffering

• Feeling of punishment

• Despair at a wasted life

 

Companionship with the the patient at this stage is important by listening and discussing fear. Many healthcare professionals avoid this topic because they believe it will upset patients. However, by engaging in this type of conversation it may help to reduce fear of dying and of the unknown. 

 

Patients should be encouraged to talk about dreams or nightmares experienced, however the meaning of the dream should not be analyzed but rather discuss any potential feeling or emotions associated. Sometimes, as a result of discussing dreams, patients can express fears  which they do not normally have the courage to bring up.

 

A sense of completeness is important to patients near death because they feel that their life has been organised and tidied. For example patients are often relieved when asked about making a will, because responsibilities can be handed over which provides a sense of peace. This makes it easier to depart life when the time arrives.